Hospital Pharmacy - December 2020 - 396

396	

Hospital Pharmacy 55(6)

Figure 3.  Level of IPA vapor escape detected in ppm throughout 16 steps in task 2 followed by six added steps repeated for 10
repetitions for six different CSTDs. (NIOSH performance threshold set at 1.0 ppm.)

Note. Data represent the range and mean values. Graph scale = A (0-250), B, C, E (0-1.2), D (0-20), and F (0-60). Also note the ppm scaling differences
between graphs. IPA= 70% isopropyl alcohol; CSTD = closed-system drug-transfer device; NIOSH = National Institute for Occupational Safety and
Health.

devices: Equashield®, HALO®, and PhaSealTM all fell below the
1.0 ppm quantifiable performance threshold for successful containment per the NIOSH draft protocol while the remaining
three CSTDs (ChemoLockTM, OnGuardTM with Tevadaptor®,
and TexiumTM with SmartSiteTM VialShield) showed average
BG-0 IPA detected levels greater than 1.0 ppm (please note the
ppm scaling differences on the individual device graphs). The
same results were observed for task 2 plus the added steps
(Figure 3). For task 2 results without the added steps, please
refer to supplemental material provided electronically.
Consequentially, means of average BG-0 and means of
BG-0max values (as seen in Table 5) for Equashield®, HALO®,
and PhaSealTM were less than 1.0 ppm for task 1 and task 2 plus
the added steps. On the contrary, ChemoLockTM, OnGuardTM
with Tevadaptor®, and TexiumTM with SmartSiteTM VialShield
means of average BG-0 and means of BG-0max were above 1.0
ppm throughout the IPA manipulation process.

Based on the performance threshold set by NIOSH, only
three of the six tested CSTD brands successfully contained
IPA: Equashield®, HALO®, and PhaSealTM.

Discussion
In 2015, NIOSH developed a draft protocol to establish testing
standards for CSTDs to determine their effectiveness in containing liquid, aerosol, and vapor states of medications during
preparation, compounding, and administration processes.39
The purpose of this study was to test six currently available
CSTDs using a modified 2015 NIOSH vapor containment performance draft protocol. In this study, three of the six tested
CSTDs (Equashield®, HALO®, and PhaSealTM) performed as
truly closed systems measured by IPA release using the Miran
SapphIRe analyzer during compounding and administration
tasks. While this study utilized the same steps in tasks 1 and 2



Hospital Pharmacy - December 2020

Table of Contents for the Digital Edition of Hospital Pharmacy - December 2020

Drug Review Updated List of Light-Sensitive Oral Medications Scott Perkins, Adam Evans, and Allison King
Original Articles Prophylactic Enoxaparin Dosing in Obese Orthopedic Patients: A Literature Search Van N. Tran, Ilya Varfolomeev, and Geoff Hill
Significant Published Articles for Pharmacy Nutrition Support Practice in 2019 Roland N. Dickerson, Angela L. Bingham, Todd W. Canada, Lingtak N. Chan, M. Petrea Cober, Sarah V. Cogle, Anne M. Tucker, and Vanessa J. Kumpf
Effect of Therapeutic Interchange on Medication Changes Between Admission and Discharge Ryan A. Popp, Kathleen A. Lusk, Shelley S. Glaess, Donna Burkett, and Rebecca L. Attridge
Evaluating Six Commercially Available Closed-System Drug-Transfer Devices Against NIOSH’s 2015 Draft Vapor Protocol Shiraz Halloush, Ivan A. Reveles, and Jim Koeller
Adjusted vs Total Body Weight–Based Dosing of Sedation and Analgesia Used in the Intensive Care Unit Julianne Yeary, Alexandra Greco, Richard McKnight, Karen Petros, Gregory Schaefer, and Jeffrey Garavaglia
Medication Safety at Home: A Qualitative Study on Caregivers of Chronically Ill Children in Malaysia Chii-Chii Chew, Amar-Singh HSS, Huan-Keat Chan, and Mohamed Azmi Hassali
Hospital Pharmacy - December 2020 - Cover1
Hospital Pharmacy - December 2020 - Cover2
Hospital Pharmacy - December 2020 - 345
Hospital Pharmacy - December 2020 - 346
Hospital Pharmacy - December 2020 - 347
Hospital Pharmacy - December 2020 - 348
Hospital Pharmacy - December 2020 - Drug Review Updated List of Light-Sensitive Oral Medications Scott Perkins, Adam Evans, and Allison King
Hospital Pharmacy - December 2020 - 350
Hospital Pharmacy - December 2020 - 351
Hospital Pharmacy - December 2020 - 352
Hospital Pharmacy - December 2020 - 353
Hospital Pharmacy - December 2020 - 354
Hospital Pharmacy - December 2020 - 355
Hospital Pharmacy - December 2020 - 356
Hospital Pharmacy - December 2020 - 357
Hospital Pharmacy - December 2020 - 358
Hospital Pharmacy - December 2020 - 359
Hospital Pharmacy - December 2020 - 360
Hospital Pharmacy - December 2020 - 361
Hospital Pharmacy - December 2020 - 362
Hospital Pharmacy - December 2020 - 363
Hospital Pharmacy - December 2020 - 364
Hospital Pharmacy - December 2020 - 365
Hospital Pharmacy - December 2020 - Original Articles Prophylactic Enoxaparin Dosing in Obese Orthopedic Patients: A Literature Search Van N. Tran, Ilya Varfolomeev, and Geoff Hill
Hospital Pharmacy - December 2020 - 367
Hospital Pharmacy - December 2020 - 368
Hospital Pharmacy - December 2020 - 369
Hospital Pharmacy - December 2020 - 370
Hospital Pharmacy - December 2020 - 371
Hospital Pharmacy - December 2020 - 372
Hospital Pharmacy - December 2020 - Significant Published Articles for Pharmacy Nutrition Support Practice in 2019 Roland N. Dickerson, Angela L. Bingham, Todd W. Canada, Lingtak N. Chan, M. Petrea Cober, Sarah V. Cogle, Anne M. Tucker, and Vanessa J. Kumpf
Hospital Pharmacy - December 2020 - 374
Hospital Pharmacy - December 2020 - 375
Hospital Pharmacy - December 2020 - 376
Hospital Pharmacy - December 2020 - 377
Hospital Pharmacy - December 2020 - 378
Hospital Pharmacy - December 2020 - 379
Hospital Pharmacy - December 2020 - 380
Hospital Pharmacy - December 2020 - 381
Hospital Pharmacy - December 2020 - Effect of Therapeutic Interchange on Medication Changes Between Admission and Discharge Ryan A. Popp, Kathleen A. Lusk, Shelley S. Glaess, Donna Burkett, and Rebecca L. Attridge
Hospital Pharmacy - December 2020 - 383
Hospital Pharmacy - December 2020 - 384
Hospital Pharmacy - December 2020 - 385
Hospital Pharmacy - December 2020 - 386
Hospital Pharmacy - December 2020 - 387
Hospital Pharmacy - December 2020 - 388
Hospital Pharmacy - December 2020 - 389
Hospital Pharmacy - December 2020 - 390
Hospital Pharmacy - December 2020 - Evaluating Six Commercially Available Closed-System Drug-Transfer Devices Against NIOSH’s 2015 Draft Vapor Protocol Shiraz Halloush, Ivan A. Reveles, and Jim Koeller
Hospital Pharmacy - December 2020 - 392
Hospital Pharmacy - December 2020 - 393
Hospital Pharmacy - December 2020 - 394
Hospital Pharmacy - December 2020 - 395
Hospital Pharmacy - December 2020 - 396
Hospital Pharmacy - December 2020 - 397
Hospital Pharmacy - December 2020 - 398
Hospital Pharmacy - December 2020 - 399
Hospital Pharmacy - December 2020 - Adjusted vs Total Body Weight–Based Dosing of Sedation and Analgesia Used in the Intensive Care Unit Julianne Yeary, Alexandra Greco, Richard McKnight, Karen Petros, Gregory Schaefer, and Jeffrey Garavaglia
Hospital Pharmacy - December 2020 - 401
Hospital Pharmacy - December 2020 - 402
Hospital Pharmacy - December 2020 - 403
Hospital Pharmacy - December 2020 - 404
Hospital Pharmacy - December 2020 - Medication Safety at Home: A Qualitative Study on Caregivers of Chronically Ill Children in Malaysia Chii-Chii Chew, Amar-Singh HSS, Huan-Keat Chan, and Mohamed Azmi Hassali
Hospital Pharmacy - December 2020 - 406
Hospital Pharmacy - December 2020 - 407
Hospital Pharmacy - December 2020 - 408
Hospital Pharmacy - December 2020 - 409
Hospital Pharmacy - December 2020 - 410
Hospital Pharmacy - December 2020 - 411
Hospital Pharmacy - December 2020 - 412
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